Fri Oct 06 2023

104 articles - From Friday Sep 29 2023 to Friday Oct 06 2023

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Am J Gastroenterol

Guidelines in Practice: The Diagnosis and Management of Gastrointestinal Subepithelial Lesions.

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Clin Gastroenterol Hepatol

PERCEPTIONS, DEFINITIONS, AND THERAPEUTIC INTERVENTIONS FOR OCCASIONAL CONSTIPATION: A ROME WORKING GROUP CONSENSUS DOCUMENT.

Occasional constipation is a unique clinical entity characterized by infrequent but recurrent symptoms. Data is limited as consensus definitions have been lacking. Establishing a standardized definition and therapeutic recommendations provides a framework for future studies focusing on epidemiologic and symptoms-based outcomes. Further studies are needed to confirm and refine these recommendations.

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Gut

British Society of Gastroenterology guidelines for the diagnosis and management of cholangiocarcinoma.

Quality of evidence is presented using the Appraisal of Guidelines for Research and Evaluation (AGREE II) format. The recommendations arising are to be used as guidance rather than as a strict protocol-based reference, as the management of patients with CCA is often complex and always requires individual patient-centred considerations.

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Meta-analysis

meta-analyses and systematic reviews

Gut

Changing prevalence of chronic hepatitis B virus infection in China between 1973 and 2021: a systematic literature review and meta-analysis of 3740 studies and 231 million people.

China has experienced remarkable decreases in HBV infection over the last four decades, but variations in HBsAg prevalence persist in subpopulations. Ongoing prevention of HBV transmission is needed to meet HBV elimination targets by 2030.

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Hepatology

Pre-emptive TIPS in high-risk acute variceal bleeding. An updated and revised individual patient data meta-analysis.

The updated two-stage IPD-MA confirms the significant survival advantage of p-TIPS in high-risk patients with cirrhosis and AVB. As a result, we recommend p-TIPS as the preferred first-choice treatment for these patients.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Antibiotic use as a risk factor for irritable bowel syndrome: Results from a nationwide, case-control study.

Prior antibiotics use was associated with an increased odds of IBS with the highest risk among people with multiple antibiotics dispensations.

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Design of the phase 3 MAESTRO clinical program to evaluate resmetirom for the treatment of nonalcoholic steatohepatitis.

The MAESTRO clinical programme was designed in conjunction with regulatory authorities to support approval of resmetirom for treatment of NASH. The surrogate endpoints, based on week 52 liver biopsy, serum biomarkers and imaging, are confirmed by long-term clinical liver-related outcomes in MAESTRO-NASH (month 54) and MAESTRO-NASH-OUTCOMES (time to event).

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In severe alcohol-related hepatitis, acute kidney injury is prevalent, associated with mortality independent of liver disease severity, and can be predicted using IL-8 and micro-RNAs.

Incident AKI is associated with 90-day mortality independent of liver function. Prednisolone therapy was associated with reduced incident AKI. IL-8 and several miRNAs are potential biomarkers to predict AKI. Novel therapies to prevent incident AKI should be evaluated in AH to reduce mortality.

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Novel symptom clusters predict disease impact and healthcare utilisation in inflammatory bowel disease: Prospective longitudinal follow-up study.

Novel model-based clusters identify patients with IBD at higher risk of adverse disease outcomes who are high-volume users of healthcare.

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Periodontal disease is not associated with risk of inflammatory bowel disease: Results from two prospective cohort studies in the US.

In two large prospective cohort studies, we did not observe an association between periodontal disease and tooth loss and risk of CD or UC.

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Prospective comparison of diagnostic tests for bile acid diarrhoea.

Diagnosis of bile acid diarrhoea using empirical treatment was inadequate. Exploration suggested considerable improvements in the sensitivity of C4-based testing, offering potential widely available diagnostics. Further validation is warranted. NCT03876717.

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Therapeutic drug monitoring of methotrexate in patients with Crohn's disease.

Five patients ended study participation or stopped methotrexate for another reason. A higher MTX-PG could be used for TDM if a target concentration can be established.

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Am J Gastroenterol

A Predictive Model to Identify the Effects of Transcutaneous Sacral Nerve Stimulation with Pelvic Floor Exercises in Faecal Incontinence after Surgery for Anorectal Malformation.

tSNS with PFEs is effective for most FI patients after CARM surgery except when rectum deviates from the puborectal muscle centre, puborectal muscle rupture occurs, or EAS is absent with a low ASP.

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ADALIMUMAB VERSUS INFLIXIMAB IN LUMINAL PEDIATRIC CROHN'S DISEASE: COMPARABLE OUTCOMES IN A PROSPECTIVE MULTICENTER COHORT STUDY.

Children with Crohn's disease achieved favourable outcomes at one year with either ADA or IFX as first antiTNF agents. Those receiving IFX did not have significantly superior outcomes compared to clinically similar children receiving ADA.

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Additional 30-second observation of the right-sided colon for missed polyp detection with texture and color enhancement imaging compared to narrow band imaging: A randomized trial.

Regarding add-30-s observation of the right-sided colon, TXI was non-inferior to NBI.

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Clinical features and treatment response to topical steroids in ethnic and racial minority patients with eosinophilic esophagitis.

Few EoE patients at our center were Hispanic, and they had similar clinical presentations as non-Hispanics. The non-White EoE group was larger, and presentation was less dysphagia-specific. Non-White patients were also less than half as likely to respond to tCS.

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Clinical outcomes after endoscopic management of low-risk and high-risk T1a esophageal adenocarcinoma: A multicenter study.

High-risk T1a EAC patients undergoing successful EET had a substantially higher rate of extra-esophageal metastases compared to low-risk T1a EAC on long term follow-up. These data should be factored into discussions with patients while selecting treatment approaches. Additional prospective data in this area are critical.

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Colorectal cancer screening receipt does not differ by 10-year mortality risk among older adults.

Past-year CRC screening does not differ by predicted 10-year mortality risk. An age-based approach to CRC screening results in under-screening of older, healthier adults and over-screening of younger adults with chronic conditions. Personalized screening with incorporation of individual life expectancy may increase the value of CRC screening programs.

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Correlations Between Relative Prevalence of Celiac Disease and Sociodemographic Variables in the United States.

CD relative prevalence is associated with indicators of economic advantage.

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Gastric Alimetry® expands patient phenotyping in gastroduodenal disorders compared to gastric emptying scintigraphy.

GA improves patient phenotyping in chronic gastroduodenal disorders in the presence and absence of motility abnormalities with increased correlation with symptoms and psychometrics compared to gastric emptying status and Rome IV criteria. These findings have implications for the diagnostic profiling and personalized management of gastroduodenal disorders.

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Maternal and Neonatal Outcomes in Vedolizumab and Ustekinumab Exposed Pregnancies: Results from the PIANO registry.

This analysis of UST and VDZ exposure during pregnancy suggests no increase in complications compared to TNFs, immunomodulators and combination TNFs/immunomodulators. No signal was found for increased placental events with either therapy. Continuation of UST and VDZ throughout pregnancy is recommended.

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OPTIMIZING TIMING OF FOLLOW-UP COLONOSCOPY: A PILOT CLUSTER RANDOMIZED TRIAL OF A KNOWLEDGE TRANSLATION TOOL.

An application that provides colonoscopy surveillance intervals may help endoscopists with guideline congruence, especially those with a lower pre-intervention congruence with guideline recommendations. (ClincialTrials.gov number, NCT04889352).

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Outcomes of a 3-year prospective surveillance in individuals at high-risk for pancreatic cancer.

PC surveillance in a fully public healthcare system is feasible, safe, and leads to early PC or pre-malignant lesions diagnoses, mostly at baseline but also over time.

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Pandemic-related changes in incidence and mortality rates of gastrointestinal cancers during 2020.

Incidence and mortality rates of GI cancers may increase in the future given pandemic-related delays in 2020.

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SIGNIFICANT REDUCTION IN THE DIAGNOSIS OF BARRETT'S ESOPHAGUS AND RELATED DYSPLASIA DURING THE COVID-19 PANDEMIC.

There was a significant decline in the number of BE and BE-related dysplasia diagnoses during the COVID-19 pandemic, with an almost 50% reduction in the amount of dysplasia diagnosed in the early pandemic. The absence of a compensatory increase in diagnoses in the pandemic-Phase II and III periods may result in deleterious downstream effects on esophageal adenocarcinoma morbidity and mortality.

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Satisfaction with life in IBS is associated with psychological burden rather than gastrointestinal symptom severity.

Higher physical and mental quality of life, but not gastrointestinal symptom severity, were independently associated with higher general life satisfaction in IBS. These findings reinforce the clinical need in IBS treatment to focus on the full extent of the disorder and not merely on gastrointestinal symptom improvement. ClinicalTrials.gov Identifier NCT00775060.

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The Association between Homelessness and Key Liver-Related Outcomes in Veterans with Cirrhosis.

Homelessness in veterans with cirrhosis is associated with increased all-cause mortality, however this is likely mediated primarily through non-liver-related factors. Future studies are needed to explore drivers of mortality and improve mitigation strategies in these patients.

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The Impact of Patient's Primary Language on Inpatient Gastrointestinal Bleeding Outcomes.

Disparities exist in GIB outcomes among patients with PLOE but these gaps narrow at hospitals with higher percentages of PLOE patients. Cultural and linguistic competence may improve outcomes in this vulnerable group.

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Transcutaneous auricular vagal nerve stimulation is effective for the treatment of functional dyspepsia: a multicenter, randomized controlled study.

Our study firstly showed that 4-week taVNS (both 10Hz and 25Hz) was effective and safe for the treatment of adult FD. (clinicaltrials.gov number NCT04668534).

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Endoscopy

Forced cold snare polypectomy is related to cold snare defect protrusions and incomplete polyp resections: A prospective observational study.

FCSP was performed on 105 polyps (8%) in this study. There is the possibility that FCSP is associated with the occurrence of CSDPs and IPR. Further studies are necessary in the future to confirm our results.

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Interval post-colonoscopy colorectal cancer following a negative colonoscopy in a fecal immunochemical test-based screening program.

Risk of iPCCRC within a FIT-based CRC screening program was low during the first years after colonos-copy but, after 2.5 years, was the same as the risk in FIT-negative individuals at 2 years, when they are reinvited for screening. Colonoscopy quality may therefore require further improvement and FIT screening interval may need to be reduced after negative colonoscopy.

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The Geometry of Cold Snare Polypectomy.

RER is more important with p-CSP than with HSP. RER and consequent RIR increases with increasing polyp size. Given the overwhelming safety of CSP, specific techniques to minimise the RER should be studied and developed.

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Gastroenterology

HBV DNA AND HBSAG LEVELS AT 24 WEEKS OFF-TREATMENT PREDICT CLINICAL RELAPSE AND HBSAG LOSS IN HBEAG NEGATIVE PATIENTS WHO DISCONTINUED ANTIVIRAL THERAPY.

Among HBeAg negative CHB patients who discontinued antiviral therapy and who did not experience clinical relapse before FU W24, serum levels of HBV DNA and HBsAg at FU W24 can be used to predict subsequent clinical relapse and HBsAg clearance. A combination of HBsAg <100 IU/mL with HBV DNA <100 IU/mL identifies patients with a low risk of relapse and excellent chances of HBsAg loss, and could potentially be used as an early surrogate endpoint for studies aiming at finite therapy in HBV.

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Gastrointest Endosc

Impact of surgery after endoscopically resected high-risk T1 colorectal cancer: results of an emulated target trial.

Our study suggests that patients with high-risk T1 CRC initially treated with endoscopic resection may not benefit from additional surgery.

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Prospective study of diagnostic yields of flexible spectral imaging color enhancement installed in colon capsule endoscopy for colorectal polyps and tumors.

CCE-FICE improved the detection rates for al CRTs except adenocarcinomas, =10 mm and protruding polyps, when compared to CCE-WL (UMIN 000021125).

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Sex Differences Impact Ergonomic Endoscopic Training for Gastroenterology Fellows.

Physical differences exist between male and female trainees, and current endoscopic equipment may not be optimized for smaller hand sizes. This study highlights the urgent need for formal ergonomic training for trainees and trainers with consideration of stature and hand size to enhance safety, comfort, and equity in the training and practice of endoscopy.

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Gut

HLA-DPA1*02:01~B1*01:01 is a risk haplotype for primary sclerosing cholangitis mediating activation of NKp44+ NK cells.

Results NKp44+NK cells were enriched in livers, and intrahepatic bile ducts of individuals with PSC showed higher expression of HLA-DP. HLA-DP haplotype analysis revealed a highly elevated PSC risk for and provide clinical and functional data implicating NKp44+NK cells that recognise HLA-DPA1*02:01-DPB1*01:01 expressed on cholangiocytes in PSC pathogenesis.

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Lactobacillus gallinarum-derived metabolites boost anti-PD1 efficacy in colorectal cancer by inhibiting regulatory T cells through modulating IDO1/Kyn/AHR axis.

Objective Gut microbiota is a key player in dictating immunotherapy response. We aimed to explore the immunomodulatory effect of probiotic is a potential adjuvant to augment anti-PD1 efficacy against CRC.

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Immunosuppressive CD29+ Treg accumulation in the liver in mice on checkpoint inhibitor therapy.

We propose that CD29 + Tregs constitute a unique subpopulation of hepatic Tregs that are primed to respond to ICI agents and mediate resistance.

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Molecular portraits of patients with intrahepatic cholangiocarcinoma who diverge as rapid progressors or long survivors on chemotherapy.

The RPLS signature could be a novel metric of chemotherapy outcome in iCCA. Further development and validation of this transcriptomic signature is warranted to develop precision chemotherapy strategies in these settings.

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Novel function of MOTS-c in mitochondrial remodelling contributes to its antiviral role during HBV infection.

MOTS-c has the potential to serve as a biomarker for the progression of HBV infection while also enhancing antiviral efficacy. These findings present a promising innovative approach for effectively treating patients with CHB. Furthermore, our research uncovers a novel role for MOTS-c in regulating MYH9-actin-mediated mitochondrial dynamics and contributing to mitochondrial biogenesis.

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Prebiotic diet changes neural correlates of food decision-making in overweight adults: a randomised controlled within-subject cross-over trial.

In this proof-of-concept study, a prebiotic intervention attenuated reward-related brain activation during food decision-making, paralleled by shifts in gut microbiota.

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Hepatology

Genomic approaches to explore susceptibility and pathogenesis of alcohol use disorder and alcohol-associated liver disease.

In this review, we described multiple genomic approaches and their implications to investigate the susceptibility and pathogenesis of both AUD and ALD. We concluded our review with a discussion of the knowledge gaps and future research on genomic studies in these two diseases.

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Risk of liver-related events in metabolic dysfunction-associated steatohepatitis (MASH) patients with fibrosis: A comparative analysis of various risk stratification criteria.

The risk of LRE is similar in patients with high-risk MASH and with F2-F4 fibrosis without MASH. The use of LSM=10 KPa or AGILE 3+ >0.67 could be an accurate option to identify MASLD patients worthy to be included in clinical trials.

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The clinical and financial burden of nonhepatocellular carcinoma focal lesions detected during surveillance of patients with cirrhosis.

Non-HCC HFL are frequently detected in patients with cirrhosis, do not impact prognosis but trigger substantial costs. This burden must be considered in cost-effectiveness analyses of future personalized surveillance strategies.

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J Neurogastroenterol Motil

Characteristics and risk factors of Functional Dyspepsia fulfilling the Rome IV Criteria overlapping with Gastroesophageal Reflux Disease, Irritable Bowel Syndrome, and Functional Constipation in South China.

FD overlap was quite common in China with high economic burden and poor quality of life, FD patients with history of gastroenteritis, anxiety, depression, and poor sleep quality were more likely to have overlap disorders. Awareness of the physical and psychosocial stressors in overlapping condition would help optimize the management of FD overlap in clinical practice.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: IBD cost evolution - transitioning from compensating lost productivity to escalating medication expenses.

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Editorial: Interaction between fibre and colonic fermentation assessed with a novel gas-sensing capsule.

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Editorial: Negative impact of diabetes mellitus and obesity on the prognosis of patients with chronic liver disease.

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Review article: The complex interplay between diet and Escherichia coli in inflammatory bowel disease.

Preclinical and some clinical trial data suggest that E. coli and other Proteobacteria interact with certain dietary components to promote gut inflammation. Well-designed clinical trials are required before dietary recommendations for disease management can be made.

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Clin Gastroenterol Hepatol

Exploring the Small Intestinal Microbiome - relationships to symptoms and Small Intestinal Bacterial Overgrowth (SIBO).

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Longitudinal Outcomes Associated with Metabolic Dysfunction-Associated Steatotic Liver Disease. A Meta Analysis of 129 Studies.

The present study emphasizes the association between MASLD and its clinical outcomes including cardiovascular, metabolic, oncological, and other outcomes. The multisystemic nature of MASLD found in this analysis requires treatment targets to reduce systemic events and end organ complications.

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Gastroenterology

Simulation model of pancreatic cancer precursors progression: "Timely" surgery does not equal "opportune" (anymore).

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J Hepatol

Ending stigmatizing language in alcohol and liver disease: A liver societies' statement.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

A Blueprint for a Comprehensive, Multidisciplinary Pancreatic Cancer Screening Program.

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A Practical Guide to Use of Mirikizumab.

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Blood-based Biomarkers for HCC Surveillance: Ready for Center Stage?

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Calendar of Courses, Symposiums and Conferences.

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Disseminated Melioidosis infection involving hepatosplenomegaly and massive extramedullary hematopoiesis.

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Endoscopic Gastric Plication in Nonalcoholic Fatty Liver Disease.

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Endoscopy: Scoping the Way Forward.

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Management of Esophageal Squamous Cell Carcinoma Invading the Muscularis Mucosa or Shallow Submucosal Layer After Endoscopic Resection.

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Not your typical endoscopic diagnosis: pancreatic pseudotumor due to metastatic renal cell carcinoma.

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Panta rhei - an unsual biliary stent in the common bile duct.

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Pelvic Floor Dysfunction in Children: Are We Overcalling It?

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Response to Bolia.

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Use of Phosphatidylethanol (PEth) Testing in Patients with Liver Disease.

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Clin Gastroenterol Hepatol

Quickstroop predicts time to development of overt hepatic encephalopathy and related hospitalizations in patients with cirrhosis.

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Stepwise fenestration via natural orifice transluminal endoscopic surgery for symptomatic polycystic liver disease (with video).

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Endoscopy

A light in the dark: Peroral cholangioscopy provides a new strategy for difficult cannulation in pancreaticobiliary maljunction.

Pubmed   Journal   ReadQx   PMC

Comments on: "Effect of pre-resection biopsy on detection of advanced dysplasia in large nonpedunculated colorectal polyps undergoing endoscopic mucosal resection".

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Complete resection of a rectal post-endoscopic-resection residual tumor including four endoclips using underwater endoscopic mucosal resection.

Pubmed   Journal   ReadQx   PMC

Digital single-operator cholangioscopy-guided endoluminal radiofrequency of an intraductal papillary mucinous neoplasia of the main pancreatic duct.

Pubmed   Journal   ReadQx   PMC

Endoscopic vacuum therapy for esophageal perforations: is it risk effective for every size of defect?

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Endoscopy E-Videos - recently published.

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Percutaneous transhepatic digital single-operator cholangioscopy-guided laser lithotripsy in treating difficult intrahepatic duct stone in surgically altered anatomy.

Pubmed   Journal   ReadQx   PMC

Should colorectal endoscopic submucosal dissection defects be closed just because we can?

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Successful closure of thoracogastric airway fistula with occluder devices and coils under fluoroscopic guidance.

Pubmed   Journal   ReadQx   PMC

Technical aspects of transpapillary biopsy for gallbladder cancer using a novel cholangioscope.

Pubmed   Journal   ReadQx   PMC

Two-point fixed pulley-traction method in endoscopic submucosal dissection for early gastric neoplasm.

Pubmed   Journal   ReadQx   PMC

Usefulness of inserting a modified single-pigtail plastic stent into a metallic stent in endoscopic ultrasound-guided gallbladder drainage.

Pubmed   Journal   ReadQx   PMC

Using a through-the-scope tack and suture system in patients with gastrointestinal wall defects: an alternative option beyond endoscopic clipping.

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Gastroenterology

A 68-year-old woman with unexplained liver enzyme elevation and active chronic hepatitis: Beware of drug induced autoimmune like hepatitis.

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Early detection of advanced adenomas and colorectal carcinoma by serum glycoproteome profiling.

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Impact of lesion location on recurrence after resection of T1 colorectal cancer: post-hoc analysis of a nationwide multicenter cohort study.

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Inflammation as a pathogenic mechanism of colonic neoplasia in primary sclerosing cholangitis.

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Gastrointest Endosc

Eroded small bowel phlebectasia - clipping of an uncommon bleeding source using motorized spiral enteroscopy.

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Lumen apposing metal stent for the management of symptomatic hepatic cyst.

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Hepatology

The utility of futility.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: Interaction between fibre and colonic fermentation assessed with a novel gas-sensing capsule-Authors' reply.

Pubmed   Journal   ReadQx 

Editorial: Negative impact of diabetes mellitus and obesity on the prognosis of patients with chronic liver disease-Authors' reply.

Pubmed   Journal   ReadQx 

Letter: Antibiotics in gut dysbiosis and development of inflammatory bowel disease-More thought is needed-Authors' reply.

Pubmed   Journal   ReadQx 

Letter: Antibiotics in gut dysbiosis and development of inflammatory bowel disease-More thought is needed.

Pubmed   Journal   ReadQx 

Letter: Entecavir versus tenofovir on serum lipoprotein levels of hepatitis B virus-related hepatocellular carcinoma after curative hepatectomy-Author's reply.

Pubmed   Journal   ReadQx 

Letter: Entecavir versus tenofovir on serum lipoprotein levels of hepatitis B virus-related hepatocellular carcinoma after curative hepatectomy.

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Letter: Incidence of hepatitis B virus reactivation in patients with psoriasis treated with cytokine inhibitors.

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Letter: NSBB for fatty liver disease-Still a long way to go.

Pubmed   Journal   ReadQx 

Letter: NSBB for fatty liver disease-Still a long way to go. Authors' reply.

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Letter: Transperineal ultrasonography for ulcerative proctitis- Applicability in the pregnant population?

Pubmed   Journal   ReadQx 

Letter: Transperineal ultrasonography for ulcerative proctitis-Applicability in the pregnant population? Authors' reply.

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Gastroenterology

NordICC's 10-year interim results are unexpected, and inconsistent with modeling predictions.

Pubmed   Journal   ReadQx 

Gut

Endoluminal radiofrequency ablation prior to stenting for malignant biliary obstruction: really time to say goodbye?

Pubmed   Journal   ReadQx 

FGF-21 analogues for treatment of non-alcoholic steatohepatitis and fibrosis: a meta-analysis with fragility index of phase 2 randomised placebo-controlled trials.

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J Hepatol

A risk prediction model for hepatocellular carcinoma after hepatitis B surface antigen seroclearance: Need a closer look!

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